No, We Aren’t ‘Murderers’ – We Are Your Doctors

The far right is now on its second month of claiming that unless new laws are put into place, abortion providers will willfully and eagerly murder newborn infants while the patient silently and complicitly watches. The utter mistrust and suspicion that anti-choice politicians have towards medical professionals who offer legal abortion care (and, frankly, to the people who seek it out) is no longer shocking. What is surprising, however, is how much the public is falling for this mistaken concept that the doctor providing abortions is somehow a completely different entity from the doctor checking your paps, inserting your IUDs and yes, even delivering your baby into the world.

One of the hardest parts of being an abortion provider is the isolation in our medical profession that is  thrust upon us by anti-choice factions. They’ve forced medical schools to outsource full-scale Ob/Gyn care that includes learning miscarriage management and abortions at all levels of gestation. They’ve made medical students opt in, rather than opt out, of learning these completely legal and necessary medical procedures, and travel off campus and further if they want to get enough training to be proficient. And they’ve removed elective abortions from hospitals and private family medical clinics and corralled them into abortion clinics and reproductive health clinics alone, as if they were an infectious disease that must be contained.

Providing an abortion is just one part of what an Ob/Gyn, or even many family doctors can and should be able to do, and an important part of the medical services spectrum that allows one doctor to see a patient through every level of that person’s medical needs at any given point in their life. Yet the right has siloed abortion into one “shameful” medical concept and annexed it from the full continuum of care, as if there are “abortion doctors” and “real doctors” rather than them being one and the same.

That same doctor that gives one pregnant person an ultrasound to see if she is early enough to use medication abortion for a termination is likely to be found a day later with another patient checking her dilation to see if she’s  in labor. Yet the right is adamant that the first one is a monster, and the second a trusted part of the medical team, despite the fact that each is the same person in a different setting.

No, we aren’t committing infanticide, or murder, or doing harm. We took oaths to protect our patients, and there are already laws to be certain that we uphold them. We are all  physicians and we are all governed by the same boards and bodies,  yet anti-choice activists have convinced you that we are different simply because of the clinic in which we provide our care.

Of course there are bad abortion providers out there, that is inescapable. There are also bad cardiologists, bad oncologists, bad surgeons and more. Yet in those specialties a rogue doctor is treated as an anomaly, and isn’t seen as tarnishing an entire profession. Yet because an abortion doctor’s specialty is relieving a patient of a pregnancy they do not want to continue, every rare instance of poor care or doctor violation is seen as the rule, not the exception.

Abortion providers, like all doctors, do what they need to do to best meet the needs of their patients. Just as you would trust a doctor to provide the best end of life care that a patient and their family requests, you can trust us as well to put the needs of the pregnant patient first and do what they want and is necessary as they deal with an unwanted pregnancy, or a pregnancy that is medically compromised.

As a doctor, I am no more likely to harm or dispose of a viable, full term fetus than any other doctor would be to murder an elderly patient simply because they are bedridden or too frail to walk. But just as most doctors will honor end of life decisions and work with a family to offer hospice when there is no hope for recovery, I too work with my own patients to make the best medical decisions for themselves and their families, too.

No one is murdering Grandma, and no one is committing infanticide, despite what anti-choice activists say. But those same activists who want to end abortion – not just later abortion, but all abortion at any point and for any reason – want to also take away your right to make end of life decisions, too. Today they are arguing to force resuscitation on fetuses on the very edge of viability against the wishes of a parent. Tomorrow, they will be focused on keeping bodies with no brain activity on life support against the wishes of the family, too. We already saw this in Texas when the state kept a brain-dead pregnant woman on life support to try to get her fetus to viability, despite her family asking them to stop. When you are legislating “life” as “conception to natural death” a family’s wishes could easily be against the law.

I am not a murder, or a monster. I am a doctor. I once delivered your babies and still do your paps, IUD’s, physical exams and STI checks, and yes, I terminate pregnancies, too. Trust me to do my  job and look out for your medical best interests at every point in your life.

After all, I trust you to make the best decisions for yourself, too.

It’s doctors – not the FDA – standing between miscarrying mothers and medical best practices

Like so many people who encountered the recent NPR piece on mothers suffering through miscarriage, my heart broke for the patients forced through the agony of waiting after using a less effective drug to end the pregnancy when there was a far quicker and more successful option available. However, that sorrow was overshadowed by the furious anger I felt for the doctors managing their care – because it is them, not the FDA – who are standing in the way of patients getting the mifepristone that would end their suffering faster.

As NPR reported, mifepristone is highly regulated, meaning a doctor does need to go through additional protocols in order to have it stocked in their office. But the actual requirements aren’t onerous at all, especially not for an OB-Gyn or other doctor doing pregnancy related or reproductive healthcare. All that is needed is for the provider to have a medical license, as well as the medical knowledge and ability to refer a miscarrying patient for a D&C should the medication fail.

Not even perform a D&C. Just refer.

Just like having Rhogam shots in the office to provide for a patient who is RH negative, or methotrexate if a patient has an ectopic pregnancy, mifepristone could easily be stocked in offices to have a supply on hand. The cost of mifepristone is the same as a Rhogam shot- nothing exorbitant! Unlike these other medications, though, mifepristone carries the stigma of being thought of as an “abortion drug,” and the added issue of drawing the attention of rabid anti-abortion activists who would rather watch women suffer and put their health in jeopardy through a drawn out miscarriage than risk the possibility that even one unwanted pregnancy might be ended with secretly in the process.

There is absolutely no reason for a hospital or doctor not to be stocking mifepristone other than complacency and cowardice in our profession. Mifepristone has been used to accelerate the process of pregnancy loss in non-viable pregnancies for two decades, with repeated studies showing that the process is both safer and more efficient. Yet every month I see patients coming in to have D&Cs after weeks of undergoing multiple rounds of misoprostol-only miscarriage management from doctors who simply don’t understand how the process works, or care enough about the physical and emotional well being of a patient who is suffering a drawn out loss of a wanted pregnancy. Patients who after waiting for a failing pregnancy to end eventually end up in a hospital surgical center with huge deductibles due for a D&C when she could have already been done and potentially trying once more to get pregnant again.

Make no mistake about it – doctors, led by abortion opponents, are letting miscarrying mothers suffer in order to punish abortion patients.

It doesn’t have to be this way. Doctors, whose first responsibility is to help their patients and provide the best care possible, could easily stock mifepristone and help any current and future mother undergoing a miscarriage – but only if they are brave enough to break the stigma around this safe, legal, efficient medication regime and stock it in their practices all across the nation. Instead, they’ve refused and tried to pin the blame on the FDA and NPR let them pass the buck.

The question is, are you going to let them pass the buck, too?